Three out of four regional public hospitals in South Korea suspended or scaled back services in the first half of this year, even as their medical workforce grew over the past four years. With about half of all clinical departments staffed by a single doctor and the number of public health doctors falling sharply, critics say regional public health care is breaking down.
The combined medical workforce at the country's 35 regional public hospitals rose 7.8% to 1,243 as of June this year from 1,153 in 2022, according to parliamentary audit data submitted by the National Federation of Regional Public Hospitals to Rep. Park Jie-won of the Democratic Party of Korea, a member of the National Assembly's Health and Welfare Committee, on the 19th. Even so, 26 hospitals, or 74.3% of the total, suspended or reduced services in the first half of this year. The disruptions affected 63 clinical departments. Outside the greater Seoul area, 22 of 26 regional hospitals, or 84.6%, reported gaps in care.
Many of the gaps have dragged on. The psychiatry department at Seosan Medical Center had been closed for 1,277 days as of the end of June, while the hematology-oncology and rheumatology departments at Busan Medical Center had each been shut for 852 days. The nearest alternative provider is 37 kilometers away for obstetrics and gynecology patients of Jinan Medical Center and 60 kilometers away for rehabilitation medicine patients of Uljin Medical Center, forcing residents to travel long distances.
Uneven staffing across departments is cited as a main cause. Of the 497 clinical departments that had any doctors as of June, 246, or 49.5%, were run by a single physician. Outside the greater Seoul area, that share rose to 51.1%. At Gunsan Medical Center, the medical workforce grew to 49 this year from 38 in 2022, yet pulmonology and nephrology services were suspended one after another when specialists retired. The two departments together handled 19,162 outpatient visits last year.
Support systems meant to offset the shortage have also fallen short. The number of public health doctors assigned to regional public hospitals halved to 38 this year from 76 in 2022. Government requests for dispatched specialists rose to 112 this year from 98 in 2024, but the number actually approved fell to 82 from 94.
Finances are also under strain. Medical revenue at regional public hospitals nationwide came to 1.3369 trillion won ($940 million) last year, against medical costs of 1.8942 trillion won, leaving a medical loss of 557.3 billion won. Twenty-two hospitals, or 62.8% of the total, have eroded their capital base. The financial burden of hiring staff and restoring normal services is also considerable.
"We need backup staffing plans so that a single retirement or the end of a public health doctor's service term does not immediately shut down a department," Park said. "The central government, local governments and university hospitals should link up on joint hiring, dispatches and rotating clinics, and the system should be improved to track whether services actually resume." The lawmaker added that authorities should review which departments at each regional public hospital are operating, how long closures have lasted and how accessible alternative providers are, while also supporting staffing for departments that have gone unfilled for long periods.